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Ketamine as a Treatment for Anorexia Nervosa: A Narrative Review

Johanna Louise Keeler, Janet Treasure, Mario F Juruena, Carol Kan, Hubertus Himmerich

Nutrients November 20, 2021 DOI: 10.3390/nu13114158 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Review Peer reviewed
Population Adults with anorexia nervosa
Intervention Ketamine
Topics Anxiety Depression Ketamine Neuroplasticity Esketamine
Keywords Anorexia nervosa Milnacipran Antidepressant Depression economics Cognition Eating disorders
Citations 55
Key findings There is ample theoretical background, via several potential mechanisms, that warrants exploring ketamine as a treatment for adults with anorexia nervosa.

Abstract

Anorexia nervosa (AN) is a highly complex disorder to treat, especially in severe and enduring cases. Whilst the precise aetiology of the disorder is uncertain, malnutrition and weight loss can contribute to reductions in grey and white matter of the brain, impairments in neuroplasticity and neurogenesis and difficulties with cognitive flexibility, memory and learning. Depression is highly comorbid in AN and may be a barrier to recovery. However, traditional antidepressants are often ineffective in alleviating depressive symptoms in underweight patients with AN. There is an urgent need for new treatment approaches for AN. This review gives a conceptual overview for the treatment of AN with ketamine. Ketamine has rapid antidepressant effects, which are hypothesised to occur via increases in glutamate, with sequelae including increased neuroplasticity, neurogenesis and synaptogenesis. This article provides an overview of the use of ketamine for common psychiatric comorbidities of AN and discusses particular safety concerns and side effects. Potential avenues for future research and specific methodological considerations are explored. Overall, there appears to be ample theoretical background, via several potential mechanisms, that warrant the exploration of ketamine as a treatment for adults with AN.

Comparable studies

Other narrative reviews on ketamine for anxiety, most cited first.

Study Year Design Participants
A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders 2017 Review and consensus statement
KETAMINE'S MECHANISM OF ACTION: A PATH TO RAPID‐ACTING ANTIDEPRESSANTS 2016 Review
Eradicating Suicide at Its Roots: Preclinical Bases and Clinical Evidence of the Efficacy of Ketamine in the Treatment of Suicidal Behaviors 2018 Review
Predictors of Response to Ketamine in Treatment Resistant Major Depressive Disorder and Bipolar Disorder Patients with treatment-resistant depressive symptoms as part of major depressive... 2018 Narrative review
Ketamine as a Fast Acting Antidepressant: Current Knowledge and Open Questions 2013 Review

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Anxiety Depression Ketamine Neuroplasticity Esketamine

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